Measles, listeria, botulism, the norovirus. Now its bubonic plague in 2015

We’ve had measles continue to make its comeback from the dead, thanks to the anti-vaccine movement. A listeria outbreak tied to ice cream. A botulism outbreak tied to canned potatoes at a church picnic. Norovirus at schools here in Palm Beach County. And now a real life Cujo or at least the dog equivalent of Typhoid Mary.

There is a real life outbreak of bubonic plague. Four people and a dog in Colorado might be the first instance of person-to-person transmission of plague in the United States in 90 years. How rare is it? It’s not even in my spell check dictionary!

NBC reports it all started with a sick pit bull, and its owner, two vet techs and a close personal contact with the dog’s owner all ended up infected. The dog died, but all four people were treated with antibiotics and are okay.

“Although human plague is rare in North America, it remains a public health concern in the western United States where Y. pestis circulates among wild rodent populations,” the researchers wrote in a report circulated by the Centers for Disease Control and Prevention.

Once among humans, the disease can be spread through cough. Called the Black Death , the plague was one of the most devastating pandemics in human history, resulting in the deaths of an estimated 75 to 200 million people and peaking in Europe in the years 1346–53. It also wiped out 25 million people in 541.

The dog got sick last summer and was euthanized at a veterinary office after it coughed up blood and became very weak. No one suspected plague until its owner got sick, too. He was initially diagnosed with another bacterial infection, but later tests showed he was infected by Yersinia pestis, better known as the bubonic plague.

The last documented case of human-to-human transmission of plague in the U.S. was during an outbreak in Los Angeles in 1924.

“We know that he got it from the dog,” Tri-County’s Janine Runfola said. “He was coughing up blood. That is likely when some of the cases got infected, including the index patient.”

Separately, two veterinary technicians who treated the dog got respiratory infections. They treated themselves with antibiotics. After the dog owner was diagnosed with plague, they were checked and put on extra intravenous antibiotics to be certain they were cured of the infection.

The most troubling case is the fourth one, a female’s close contact with the dog’s owner. Health officials are trying hard not to identify any of the people involved to protect their privacy.

“She also had contact with the dog and also had more intensive contact with the patient when he got sick,” Douglas said. Both the man and the dog were coughing up blood, so either could have infected her. But the timeline makes it look more likely that the man infected her.

“There’s no way to be sure that she also didn’t get it from the dog,” Douglas notes. “Don’t let your dog run around where the prairie dogs are.”

In 2012, a 7-year-old Denver girl caught bubonic plague from a dead squirrel but she didn’t spread it.

The good news is that all forms of plague can be treated with antibiotics if diagnosed properly.

“If you live in the West and you live in places where there are rodents or you are hiking … you need to be generally aware,” Douglas said. “Don’t let your dog run around where the prairie dogs are. Wear insect repellent and socks,” he advised.